| NPI | 1952675324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO Psy.0005374) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO Psy.0005374) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CO Psy.0005374) | |
| 103TC0700X Psychologist, Clinical (Licence: CO Psy.0005374) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CO Psy.0005374) | |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2020-12-01 |