| NPI | 1396039848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 680) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4078) |
| 133V00000X Dietitian, Registered (Licence: SC 17) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |