| NPI | 1174664502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1310PsychologicalAss) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C002329LCSW) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |