| NPI | 1720209307 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3410) | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AZ 3410) | 
| 103TC0700X Psychologist, Clinical (Licence: AZ 3410) | |
| Enumeration Date | 2007-05-01 | 
| Last Update Date | 2009-11-09 |