| NPI | 1811932452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 1693057) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1693057) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2010-12-27 |