| NPI | 1821150632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS005349L) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS005349L) |
| 103TS0200X Psychologist, School (Licence: PA PS005349L) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-07-08 |