| NPI | 1952927600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL 10538) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 002436) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-06-18 |