| NPI | 1750965067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ PSY-005887) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MO 2022012231) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2025-06-09 |