| NPI | 1972189264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: 2771) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: 2771) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA 2771) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2024-07-17 |