| NPI | 1992751721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 2530) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WV 893) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2010-02-18 |