| NPI | 1548478324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: VA 0810001783) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810001783) |
| 103TH0100X Psychologist, Health Service (Licence: VA 0810001783) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |