| NPI | 1114049962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810-005129) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1623057) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2016-04-04 |