| NPI | 1285789131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 3695) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 3707) |
| 103T00000X Psychologist (Licence: RI PS00763) | |
| 103TC0700X Psychologist, Clinical (Licence: VA 0819992862) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2007-07-08 |