| NPI | 1225343718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 1000) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: WV 1000) |
| 103TC0700X Psychologist Clinical (Licence: WV 1000) | |
| 103TC1900X Psychologist Counseling (Licence: WV 1000) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WV 1000) | |
| 103TF0000X Psychologist Family (Licence: WV 1000) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2014-04-10 |