| NPI | 1760429088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 02802) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810002219) |
| 103TC0700X Psychologist, Clinical (Licence: MD 02802) | |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000668) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-12-05 |