| NPI | 1164536835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5002) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY 5002) |
| 103T00000X Psychologist (Licence: FL PY 5002) | |
| 103TF0200X Psychologist Forensic (Licence: FL PY 5002) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY 5002) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: FL PY 5002) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-04-02 |