| NPI | 1235333667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WY 515) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 515) |
| 103TC1900X Psychologist, Counseling (Licence: WY 515) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-04-12 |