| NPI | 1255591152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017032) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2011-09-06 |