| NPI | 1497047799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2859 - 057) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IN 20040711A) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-08-23 |