| NPI | 1295980217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 1644) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: IN 20042385A) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2012-09-10 |