| NPI | 1952488025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2010033643) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 002672) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-05-19 |