| NPI | 1669454088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2800) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 6989-123) |
| Enumeration Date | 2005-11-20 |
| Last Update Date | 2009-05-18 |