| NPI | 1154615664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003092) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8962) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |