| NPI | 1811069107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 1116) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 1116) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-09 |