| NPI | 1982890240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00964) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 00964) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2021-09-16 |