| NPI | 1952403214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VT 869) |
| 103TC0700X Psychologist, Clinical (Licence: VT 869) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2016-06-01 |