| NPI | 1164799938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 785) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 785) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2017-04-07 |