| NPI | 1982813150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 001276) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MT 316) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-10-03 |