| NPI | 1023416161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10082) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MS 54948) |
| 103T00000X Psychologist (Licence: CO PSY0005770) | |
| 103TC0700X Psychologist, Clinical (Licence: MS 54948) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY10082) | |
| Enumeration Date | 2014-12-05 |
| Last Update Date | 2022-05-04 |