| NPI | 1821053141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS4914-L) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS4914L) |
| 106H00000X Marriage & Family Therapist (Licence: PA MF000069) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2010-01-21 |