| NPI | 1316025604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS-005502) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS005502L) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-08-30 |