| NPI | 1083686802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 488) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY7268) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2014-03-19 |