| NPI | 1154668861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10072) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 004740) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2023-09-29 |