| NPI | 1255464954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0803000119) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: VA 0803000119) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |