| NPI | 1528093192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1012) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2004005470) |
| 103TC0700X Psychologist, Clinical (Licence: KS LP1012) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-02-13 |