| NPI | 1205133766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PR 3873) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: PR 3873) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2011-02-18 |