| NPI | 1386751139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 2225) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: CO 71631) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-07-29 |