| NPI | 1225078041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 0480000655) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH 798) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |