| NPI | 1093925901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: Certif 1-05-2112) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT 2127) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |