| NPI | 1588659643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AL 712) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: AL 712) |
| 103T00000X Psychologist (Licence: AL 712) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2007-07-08 |