| NPI | 1740204650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04066) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04066) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-12-02 |