| NPI | 1952448516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 0958) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: SC 000457) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-08 |