| NPI | 1598813073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0057921) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7094) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-12-01 |