| NPI | 1164889358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY13068) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2025-12-04 |