| NPI | 1063056695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: FL SS1056) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW00004656) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |