| NPI | 1205996006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ME PS1200) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 3342) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-08-10 |