| NPI | 1154545812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY0004157) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: FL PY0004157) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: FL PY 0004157) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |