| NPI | 1396803276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS015303) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: PA 9847267) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2009-10-26 |