| NPI | 1578879672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 4822) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS016706) | 
| Enumeration Date | 2010-08-26 | 
| Last Update Date | 2019-07-29 |