| NPI | 1386718120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS005769L) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: PA PS-005679-L) |
| 103T00000X Psychologist (Licence: PA PS-005769-L) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |