| NPI | 1487623039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY6279) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1330) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |