| NPI | 1558477166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 003237) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS015523) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-12-07 |