| NPI | 1932680741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS019034) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 3751) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 3751) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2020-06-09 |