| NPI | 1962282962 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent | 
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy | 
| 103TS0200X Psychologist, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-10-05 | 
| Last Update Date | 2023-10-05 |