| NPI | 1316915697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SD 468) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: SD 468) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2013-01-03 |