| NPI | 1861760746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 01975) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MD 01975) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |