| NPI | 1083796338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05114) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000789) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2012-11-01 |