| NPI | 1851503148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 1420) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DC 1090) |
| 103T00000X Psychologist (Licence: PA PS004626L) | |
| 103TC0700X Psychologist Clinical (Licence: VA 0810000941) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |