| NPI | 1780657395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017978) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WV 826) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2016-01-06 |