| NPI | 1851787055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3651) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 3591) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 3651) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-03-16 |