| NPI | 1902873680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: KS 1124) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 002345) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2009-02-25 |