| NPI | 1033357785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7240) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: FL PY7240) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL PY7240) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY7240) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: FL PY7240) | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2015-11-18 |