| NPI | 1629086053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 1047) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY002660) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2014-01-28 |