| NPI | 1790950129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8708) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS016546) |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2010-03-10 |