| NPI | 1063579605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5224) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: DC MT0431) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2017-12-22 |