| NPI | 1831307974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 00966) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: MO 00966) |
| 106H00000X Marriage & Family Therapist (Licence: MO 300072) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |