| NPI | 1093756546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1995) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH 801) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-12-30 |