| NPI | 1164768800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS002977L) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MFT000265) |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2012-12-28 |