| NPI | 1427166628 |
|---|---|
| Doing Business As | |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 53445-030) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2380-057) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2007-07-08 |