| NPI | 1982655676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MT 342) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2025-05-23 |