| NPI | 1174556765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8143) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 963) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2019-07-28 |