| NPI | 1407853625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3087) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 1077) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2007-07-09 |