| NPI | 1801876552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.011267) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IL 149.011267) |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: IL 149.011267) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 149.011267) | |
| 251S00000X Community/Behavioral Health (Licence: IL 149.011267) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-05-11 |