| NPI | 1528233673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 00598) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: IA 598) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |