| NPI | 1760612733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 3354) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PR 4895) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2009-08-05 |