| NPI | 1861809592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TN 3302) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN 3302) |
| 103TC1900X Psychologist Counseling (Licence: TN 3302) | |
| 103T00000X Psychologist (Licence: TN 3302) | |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2024-05-27 |