| NPI | 1053312264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 047.0097608) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS007210L) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2013-10-16 |