| NPI | 1861634255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1990) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OR 1990) |
| 103TC1900X Psychologist, Counseling (Licence: OR 1990) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 1990) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OR 1990) | |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2022-07-21 |