| NPI | 1063563161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ME PS1191) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8121) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2008-10-23 |