| NPI | 1174624589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5016) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY5016) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2019-05-14 |