| NPI | 1053583120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8603) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 851) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY5819) | |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2013-04-04 |