| NPI | 1053633131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016444) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000783) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |