| NPI | 1538283916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: DC 1000739) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP4927) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2013-06-21 |