| NPI | 1174739023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MT 351) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2635) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |