| NPI | 1669503611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: DC LC50077759)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 12211)  | 
| Enumeration Date | 2007-03-08 | 
| Last Update Date | 2007-07-08 |