| NPI | 1851387963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO PY01839) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: FL PY8967) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2015-10-19 |