| NPI | 1700963964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 9600680) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: NC 92) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-07-01 |