| NPI | 1861809592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TN 3302) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TN 3302) |
| 103TC0700X Psychologist, Clinical (Licence: TN 3302) | |
| 103TC1900X Psychologist, Counseling (Licence: TN 3302) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2022-04-08 |