| NPI | 1710147228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4898) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: NC 8405) |
| 171W00000X Contractor (Licence: NC 4898) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2016-12-13 |