| NPI | 1790707719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: LA 971) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 971) |
| 103TC0700X Psychologist, Clinical (Licence: TN 2974) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 2974) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-09-28 |