| NPI | 1710994140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: DC 1000145) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810001315) |
| 103TC0700X Psychologist, Clinical (Licence: MD 02047) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |