| NPI | 1326265810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810002585) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2011019793) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-01-25 |