| NPI | 1568743987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS009077L) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: PA 8949017) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |