| NPI | 1942610258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 4316) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2016-03-10 |