| NPI | 1649563735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: MA 453081) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AK 4041880) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2013-09-24 |