| NPI | 1629169263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 1020) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 00887) |
| 103TH0100X Psychologist, Health Service (Licence: IA 000490) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-02-21 |