| NPI | 1104021831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 7479) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY 7479) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY 7479) | |
| 106H00000X Marriage & Family Therapist (Licence: FL MT 2165) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2007-07-08 |