| NPI | 1053487009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 1624) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 70880) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |