| NPI | 1831131689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 0169) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 272) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |