| NPI | 1063628840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810002063) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 03317) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |