| NPI | 1063791861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11223) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 0004929) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.0004929) | |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2023-01-19 |