| NPI | 1770265027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: UT 13531066-2501) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 13531066-2501) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-03-07 |