| NPI | 1639474984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4070) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 1608) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |