| NPI | 1639117575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 1199) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2003030100) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2009-07-02 |