| NPI | 1184751604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 05644) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TN P0000002884) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2016-02-01 |