| NPI | 1568890549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3592) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04089) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |