| NPI | 1376776179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: HI 1120) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CO 3295) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2012-12-21 |