| NPI | 1205854825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3233) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY4102) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2009-07-09 |