| NPI | 1033210570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: ND 348) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ND 348) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: ND 348) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-11-03 |