| NPI | 1043374572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NE 858) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 3272) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2014-09-04 |