| NPI | 1073520771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 275) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WV 22019) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2009-02-12 |