| NPI | 1902884638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY 2874) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CO PSY 2874) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2011-10-24 |