| NPI | 1275758989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016058) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PSO16058) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2016-01-27 |