| NPI | 1417185380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4010) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04475) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2010-10-04 |