| NPI | 1043302953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC psy568) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 02864) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-08 |