| NPI | 1962568980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 2139) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 403) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2007-07-08 |