| NPI | 1770673717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1768) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3095) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-09 |