| NPI | 1124015599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY 5906) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MD 2765) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 3700) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-11-04 |