| NPI | 1669512331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8682) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MA 8682) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2011-07-11 |