| NPI | 1124131347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID PSY202202) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 1193) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2012-12-13 |