| NPI | 1366626194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017316) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 003332) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2013-08-20 |