| NPI | 1215028006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 2582) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 2582) |
| 103T00000X Psychologist (Licence: MD 2582) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2011-10-10 |