| NPI | 1568563161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 08100001917) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-03-18 |