| NPI | 1215919725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 1009) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: IA 00483) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |