| NPI | 1174800882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017100) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS017100) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2013-07-29 |