| NPI | 1710247341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: IA 001267) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 001267) |
| 103TH0100X Psychologist, Health Service (Licence: IA 001267) | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-06-21 |