| NPI | 1003949728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC PSY1000180) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 3621) |
| 103TC0700X Psychologist Clinical (Licence: VA 0810000355) | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |