| NPI | 1457335606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8224) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NM 1024) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2011-01-10 |