| NPI | 1114028461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8922) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 04092) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2016-06-16 |