| NPI | 1770703175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1291) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 2002015380) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2007-07-08 |