| NPI | 1760401731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2006023184) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1687) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-06-14 |