| NPI | 1336111475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NH 1115) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY6867) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2008-05-14 |