| NPI | 1548320815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 3397) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NV PY0499) |
| 103T00000X Psychologist (Licence: NV PY0499) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2011-04-06 |