| NPI | 1063628659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS005583L) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000386) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |