| NPI | 1679764641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS003945L) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: PA PS003945L) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |