| NPI | 1003045477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20042454A) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: IL 071007565) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071007565) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2011-05-16 |