| NPI | 1457392516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 0639) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 0639) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-09-07 |