| NPI | 1750435103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 524) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 407) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2009-03-26 |