| NPI | 1376685842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 01771) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC 1317) |
| 103T00000X Psychologist (Licence: MD 01771) | |
| 103T00000X Psychologist (Licence: DC 1317) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |