| NPI | 1477569929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1058) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 1058) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2010-03-22 |