| NPI | 1700918067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC 939) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 1133) |
| 103T00000X Psychologist (Licence: DC 939) | |
| 103T00000X Psychologist (Licence: MD 1133) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2010-12-22 |