| NPI | 1740229079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 1917-057)  | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: WI R320000003710)  | 
| Enumeration Date | 2006-06-05 | 
| Last Update Date | 2022-08-04 |