| NPI | 1235101635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 640) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IN 20040412) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2007-07-08 |