| NPI | 1780782433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04288) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 6342) |
| 103TC0700X Psychologist, Clinical (Licence: DC PSY1000405) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-08-21 |