| NPI | 1659335008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016826) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA PC003303) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2010-09-30 |