| NPI | 1003047739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016465) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004130) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2016-08-02 |