| NPI | 1205011400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0003917) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: UT 5714120-2501) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2016-05-16 |