| NPI | 1174778740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004230) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WY 471) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2010-03-29 |