| NPI | 1902833643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2190) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2190) |
| 103TC1900X Psychologist Counseling (Licence: NC 2190) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2007-07-08 |