| NPI | 1205935756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2045-057) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: WI 2045-057) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-04-02 |