| NPI | 1003990607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04720) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY461) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-09-12 |