| NPI | 1063661767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OK 1165) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 2891) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2014-02-07 |