| NPI | 1699047860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 1034) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY003401) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |