| NPI | 1760630768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 04653) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL 7615) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-01-30 |