| NPI | 1750482253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ AZ1319) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 1319) |
| 103TC0700X Psychologist Clinical (Licence: AZ 1319) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: AZ 1319) | |
| 103TS0200X Psychologist School (Licence: AZ 1319) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-10-27 |