| NPI | 1962626226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 03869) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 1284) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2011-02-25 |