| NPI | 1821103243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-000430) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: WI 224-058) |
| 106H00000X Marriage & Family Therapist (Licence: WI 24-124) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |