| NPI | 1700039898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9680) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1089) |
| 103T00000X Psychologist (Licence: CT 2912) | |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2013-09-16 |