| NPI | 1457370769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 570) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: WI 570) |
| 103TH0100X Psychologist, Health Service (Licence: WI 570) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |