| NPI | 1609810035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS 008624-L) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS 008624-L) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-06-14 |