| NPI | 1073626255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL FLPY5489) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY5489) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-05-08 |