| NPI | 1336101393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3817) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 01306) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2010-07-20 |