| NPI | 1548484231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 04344) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DC PSY1000609) |
| 103TC0700X Psychologist Clinical (Licence: GA PSY003113) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2010-12-19 |