| NPI | 1891194155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3305) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2015-09-22 |