| NPI | 1104857739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TF0000X Psychologist Family |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |