| NPI | 1043560618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PSOO5958L) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL SS1137) |
| 103TC0700X Psychologist Clinical (Licence: PA PS005958L) | |
| 1041C0700X Social Worker Clinical (Licence: FL SW10442) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2020-05-06 |