| NPI | 1194967935 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004057) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000541) | 
| Enumeration Date | 2009-03-25 | 
| Last Update Date | 2009-03-25 |