| NPI | 1760565949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2175) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 2175) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2175) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: NC 2175) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2011-05-03 |