| NPI | 1306168273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301014150) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.007790) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2011-12-01 |