| NPI | 1225339153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 1064) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WV 1064) |
| 103TF0200X Psychologist Forensic (Licence: WV 1064) | |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2015-01-09 |