| NPI | 1871607481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 1935) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AZ 0295) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-10-22 |