| NPI | 1396708863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4119) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: SC 628) |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-07-20 |