| NPI | 1710969514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS006926L) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: PA MF000031) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2007-07-08 |