| NPI | 1790112803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017443) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC003368) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |