| NPI | 1245559152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC PSY1508) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 04611) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2010-09-15 |