| NPI | 1932271830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810001801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001127485) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-07-08 |