| NPI | 1770806754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4336) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4336) |
| 103T00000X Psychologist (Licence: NC 4336) | |
| 103TF0000X Psychologist, Family (Licence: NC 4336) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 4336) | |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2012-09-04 |