| NPI | 1407050222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS T-LP 1784) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2007029985) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2009-09-02 |