| NPI | 1578754784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 001309) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS00972) |
| 103TC0700X Psychologist, Clinical (Licence: IA 000604) | |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2013-03-20 |