| NPI | 1851416549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 03558) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DC 1000019) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |