| NPI | 1376672469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 33324) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 33324) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |