| NPI | 1750091120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 6751) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 6751) | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |