| NPI | 1154316529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00941) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: IA 00941) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IA 00941) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |