| NPI | 1255436770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS0088804L) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS-008804-L) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-03-06 |