| NPI | 1154506525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3728) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 102749) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2013-01-16 |