| NPI | 1548564487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS008892L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DE B1-0000875) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |