| NPI | 1972678399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO PY01208) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 0000300049) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-11 |