| NPI | 1093757791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY10741) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: ND 295) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2021-08-28 |