| NPI | 1730264821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 8401) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA 2377) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-04-19 |