| NPI | 1790262822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 112494) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 112494) |
| Enumeration Date | 2018-07-21 |
| Last Update Date | 2022-03-16 |