| NPI | 1811967581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 2-5250) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS009206L) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2008-09-18 |