| NPI | 1114071784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 441) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 441) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |