| NPI | 1043268758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 531) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO PY01846) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-07-23 |