| NPI | 1134100381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6194) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY6104) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY6194) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY6194) | |
| 103T00000X Psychologist (Licence: FL PY6194) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2012-11-30 |