| NPI | 1861541260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 881) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 30864) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |