| NPI | 1023196664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist Forensic (Licence: NC 2555) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS 007133-L) |
| 103T00000X Psychologist (Licence: NC 2555) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: NC 2555) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2555) | |
| 103TC1900X Psychologist Counseling (Licence: NC 2555) | |
| 103TF0000X Psychologist Family (Licence: NC 2555) | |
| 103TH0100X Psychologist Health Service (Licence: NC 2555) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 2555) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NC 2555) | |
| 103TR0400X Psychologist Rehabilitation (Licence: NC 2555) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-08-01 |