| NPI | 1730222381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016245) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 21334) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-07-12 |