| NPI | 1619009594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 3948) |
| Additional Taxonomies | 103TS0200X Psychologist School |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-03-31 |