| NPI | 1750424537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 787) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 787) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: LA 787) | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2011-10-26 |