| NPI | 1770646879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: RI 413) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 4373) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2010-07-28 |