| NPI | 1023368644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9109) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: FL PY9109) |
| 103TF0200X Psychologist Forensic (Licence: FL PY9109) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2023-08-03 |