| NPI | 1063767846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY 8550) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY 8550) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: FL PY 8550) | |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |