| NPI | 1104995547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33100) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810003393) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2008-03-04 |