| NPI | 1558414797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NH 912) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7751) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2011-01-14 |