| NPI | 1861745440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05234) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 05234) |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2022-07-21 |