| NPI | 1659555803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016628) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: WA PY00003729) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2011-10-14 |