| NPI | 1215957717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0069422) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY5664) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-01-07 |