| NPI | 1881878916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS LP03197) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: KS T-LP1703) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2023-01-18 |