| NPI | 1861570335 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS015499) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN288343L) | 
| Enumeration Date | 2006-11-01 | 
| Last Update Date | 2017-01-13 |