| NPI | 1275735169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3423) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2003011960) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2008-01-30 |