| NPI | 1588994628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 09-17P) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 9037) |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2010-01-13 |