| NPI | 1023121894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY6994) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY6994) |
| 103TC1900X Psychologist Counseling (Licence: FL PY6994) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-11-21 |