| NPI | 1912454125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 103TF0000X Psychologist, Family |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |