| NPI | 1407122021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TF0200X Psychologist, Forensic | |
| 103TH0004X Psychologist, Health | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |