| NPI | 1053747345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6961) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6961) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY6961) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY6961) | |
| 103TS0200X Psychologist, School (Licence: FL PY6961) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |