| NPI | 1821053547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3675) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 3675) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2013-05-22 |