| NPI | 1689802456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 05301) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: LA 1104) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2013-12-11 |