| NPI | 1083680490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6084) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 3918) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-11-02 |