| NPI | 1679793897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2004024741) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.007644) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2012-07-23 |