| NPI | 1003825688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0180004170) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AR 011P) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2015-09-07 |