| NPI | 1790091254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1653) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 1653) |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2011-02-22 |