| NPI | 1639312614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 103TC0700X) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 26625) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2014-09-22 |