| NPI | 1457331407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: PA 6580607) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2294) |
| 103T00000X Psychologist (Licence: CO 3212) | |
| 103TS0200X Psychologist, School (Licence: CO 49984) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2014-10-21 |