| NPI | 1174756324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1229) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: NV py0587) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2012-09-21 |