| NPI | 1356509541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 071007324) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.007324) | |
| Enumeration Date | 2008-05-25 |
| Last Update Date | 2008-08-25 |