| NPI | 1376633180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 02263) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1728) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2010-01-20 |