| NPI | 1184752495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: SC 1042) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1042) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: SC 1042) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |