| NPI | 1194023622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9460) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY003430) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2016-12-22 |