| NPI | 1992145619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3318) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS T-LMLP 2480) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3318) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2015-11-11 |