| NPI | 1982773289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00698) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: IA 00937) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |