| NPI | 1073626545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OK 1022) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AR 06-09P) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2011-11-03 |