| NPI | 1386773497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810002069) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03004) |
| 103TC0700X Psychologist Clinical (Licence: MA 7003) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VA 0810002069) | |
| 103T00000X Psychologist (Licence: VA 0810002069) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2010-06-30 |