| NPI | 1043516487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MS 51885) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1657) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2012-03-29 |