| NPI | 1932401122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2964) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 2242) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2010-11-22 |