| NPI | 1588992481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 01014) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.004619) |
| 103TC0700X Psychologist, Clinical (Licence: KS 1031) | |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2009-12-03 |