| 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 |