| NPI | 1992728638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TP0814X Psychologist Psychoanalysis | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-08-09 |