| NPI | 1760638944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003783) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY002965) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |