| NPI | 1528098456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NH 1076) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VT 048-852) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-02-28 |