| NPI | 1073050415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY9778) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY9778) |
| 103TF0200X Psychologist, Forensic (Licence: FL PY9778) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-03-03 |