| NPI | 1619066107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04665) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 1650) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2010-01-07 |