| NPI | 1710069109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6073) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MA 6073) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |