| NPI | 1467724203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9396) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7288) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |