| NPI | 1881632693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: FL OS11029) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: HI DOS-1098) |
| 251S00000X Community/Behavioral Health (Licence: MA 239772) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2013-11-04 |