| NPI | 1578600219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 2047) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WI 1363057) |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |