| NPI | 1194015842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA 10319) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 34085) |
| 103T00000X Psychologist (Licence: HI 1218) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2012-09-20 |