| NPI | 1437186426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9010) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VT 048-0000877) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2012-08-29 |