| NPI | 1972616076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: MS 45-736) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MS 45736) |
| 103TC0700X Psychologist, Clinical (Licence: LA 1140) | |
| 103TH0004X Psychologist, Health (Licence: LA 1140) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2011-11-30 |