| NPI | 1962610162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4123) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 822) |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2007-07-08 |