| NPI | 1942449814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 0801) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 02164) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2009-02-16 |