| NPI | 1588760698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS015250) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6247) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-09 |