| NPI | 1174768584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3217) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1099) |
| Enumeration Date | 2008-12-14 |
| Last Update Date | 2015-07-31 |