| NPI | 1821720954 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: UT 12417605-2501)  | 
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: UT 12417605-2501)  | 
| Enumeration Date | 2022-06-28 | 
| Last Update Date | 2023-01-23 |