| NPI | 1023175742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC PSY844) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 1122) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |