| NPI | 1730134628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: GA PSY002682) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MA 7718) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |