| NPI | 1730750324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AL 2305) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 12672) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2023-08-01 |