| NPI | 1174289250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY11189) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY11189) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL PY11189) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: FL PY11189) | |
| Enumeration Date | 2021-11-12 |
| Last Update Date | 2022-02-22 |