| NPI | 1184654865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301007707) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS-007741-L) |
| 103TC0700X Psychologist, Clinical (Licence: WV 315) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2007-07-08 |