| NPI | 1780053223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY10528) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4541) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2022-11-08 |