| NPI | 1144205741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 4956) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 987) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2010-10-22 |