| NPI | 1346310356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2003030101) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1248) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2015-07-14 |