| NPI | 1831318625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: OR 1505) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 1505) |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: OR 1505) | |
| 103TS0200X Psychologist School (Licence: OR 1505) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-08 |