| NPI | 1700990389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8274) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 789) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |