| NPI | 1245514256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 4061) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8321) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2011-10-10 |