| NPI | 1912922121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS 005138-L) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PA PS 005138-L) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: PA PS 005138-L) | |
| 103T00000X Psychologist (Licence: PA PS005138L) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |