| NPI | 1164558318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0700X Psychologist Adult Development & Aging (Licence: MA 6462) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 6462) |
| 103TF0000X Psychologist Family (Licence: MA 6462) | |
| 103T00000X Psychologist (Licence: MA 6462) | |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2007-07-08 |