| NPI | 1043352149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IN 20040435A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME R022416) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |