| NPI | 1952677023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 001233) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IA 001233) |
| 103TC1900X Psychologist Counseling (Licence: IA 001233) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: IA 001233) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2025-06-19 |