| NPI | 1316256175 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04583)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 3640)  | 
| 103TC1900X Psychologist, Counseling (Licence: MD 04583)  | |
| Enumeration Date | 2010-09-28 | 
| Last Update Date | 2010-09-28 |