| NPI | 1891991055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CO PSY.4004) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 33019) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-02-12 |