| NPI | 1801046057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 2940) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DC 1673) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: VA 2033) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 3182) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |