| NPI | 1043424807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1340) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 3154) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2015-08-21 |