| NPI | 1730393489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 280) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WY 280) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2014-01-30 |