| NPI | 1134390115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.006707) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: IL 071006707) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2009-02-23 |