| NPI | 1821055872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3164) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 1279) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2014-09-26 |