| NPI | 1912340217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PR 1059) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PR 1059) |
| 103TC0700X Psychologist, Clinical (Licence: PR 1059) | |
| 103TC1900X Psychologist, Counseling (Licence: PR 1059) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-04-17 |