| NPI | 1659418499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NH 1068) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8182) |
| 103TF0200X Psychologist, Forensic (Licence: NH 1068) | |
| 103TF0200X Psychologist, Forensic (Licence: MA 8182) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |