| NPI | 1871992578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS019119) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: PS019119) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PS019119) | |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2020-10-27 |