| NPI | 1962951335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 6221) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 06601) |
| 103TC0700X Psychologist Clinical (Licence: NC 6221) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 06601) | |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2023-08-02 |