| NPI | 1679865992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3100-57) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8575) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2015-01-13 |