| NPI | 1437234002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2004013225) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KS 1243) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2007-10-10 |