| NPI | 1841403151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017081) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2012-02-15 |