| NPI | 1750698007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2010032214) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: KS 1901) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-11-22 |