| NPI | 1013297183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3529) |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 3529) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |