| NPI | 1306812144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MA 5418) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: NC 4750) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2007-07-08 |