| NPI | 1760726640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05456) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05456) |
| 103TF0000X Psychologist, Family (Licence: MD 05456) | |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2014-10-06 |