| 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 |