| NPI | 1346452901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2699) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC0700X Psychologist, Clinical (Licence: NC 2699) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 2699) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NC 2699) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2013-11-18 |