| NPI | 1578699930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 894) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: WV 894) |
| 103TC0700X Psychologist Clinical (Licence: WV 894) | |
| 103TC1900X Psychologist Counseling (Licence: WV 894) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WV 894) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2011-03-14 |