| NPI | 1124174578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 1083) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: AZ 1083) |
| 103TF0200X Psychologist, Forensic (Licence: FL 4818) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |