| NPI | 1245410463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 2805) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC 1634) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |