| NPI | 1770579823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PA PS004994L) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS004994L) |
| 103TF0000X Psychologist Family (Licence: PA PS004994L) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2007-07-09 |