| NPI | 1891005625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016362) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS016362) |
| 103TH0004X Psychologist, Health (Licence: PA PS016362) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2018-01-23 |