| NPI | 1972159978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC 1001539) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2023-07-06 |