| NPI | 1972908010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MO 2009031094) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: MO 2009031094) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |