| NPI | 1407969538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 759) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2918) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2016-04-29 |