| NPI | 1083781488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2876-057) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WI 7074 123) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2014-04-29 |