| NPI | 1063500130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC PSY1000292) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 04145) |
| 103TC0700X Psychologist Clinical (Licence: VA 0810003455) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-06-14 |