| NPI | 1255630828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004353) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2011-10-06 |