| NPI | 1417024522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301008062) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6401005834) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |