| NPI | 1013062322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY5138) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2009-11-25 |