| NPI | 1780997817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2010031033) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2010-07-18 |
| Last Update Date | 2010-09-21 |