| NPI | 1073749891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: LA 1029) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: LA 1029) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: LA 1029) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2011-12-06 |