| NPI | 1376872705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3651) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MT 408) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2014-09-20 |