| NPI | 1528376829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 3819) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DC PSY1000635) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2011-11-15 |