| NPI | 1639294747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2604) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 768) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2011-07-29 |