| NPI | 1922171859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY2745) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 1151) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |