| NPI | 1902164312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS018032) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2016-08-11 |