| NPI | 1770640229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS008244L) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS008244L) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2009-07-13 |