| NPI | 1740264639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AR 11-11P) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 0785) |
| Enumeration Date | 2005-12-03 |
| Last Update Date | 2014-07-23 |