| NPI | 1649337213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7606) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 374) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |