| NPI | 1356421663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: TN 2797) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA PSY002962) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-09-17 |