| NPI | 1104046168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: WI 69036) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: WI 69036) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |