| NPI | 1649388760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4066) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NV PY0419) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2010-01-26 |