| NPI | 1396962940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2515) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC COO3292) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |