| NPI | 1063536761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 4022) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 4022) |
| 103TH0100X Psychologist, Health Service (Licence: MA 4022) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |