| NPI | 1902058589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 799) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: LA 799) |
| 103TC0700X Psychologist, Clinical (Licence: LA 799) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: LA 799) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2012-06-29 |