| NPI | 1912991852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 1909) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: AZ AP2219) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2008-01-09 |