| NPI | 1912945809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 20481) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 010977) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2007-07-09 |