| NPI | 1861612871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WVLPC1063) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WVPSYCHOLOGIST783) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-07-08 |