| NPI | 1619211976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 1206) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: PR 1206) |
| 103TF0000X Psychologist Family (Licence: PR 1206) | |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2012-11-26 |