| NPI | 1376686394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 447) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WY 447) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WY 447) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: WY 447) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2014-01-01 |