| NPI | 1720454549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 4215) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 4215) |
| Enumeration Date | 2015-08-16 |
| Last Update Date | 2015-08-16 |