| NPI | 1629306758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: CO PSY 3452) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: CO PSY 3452) |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2010-09-23 |