| NPI | 1801972815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 366) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 4456) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |