| NPI | 1508807835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 439) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 41) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2014-10-14 |