| NPI | 1194322826 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10782)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.010289)  | 
| Enumeration Date | 2020-10-06 | 
| Last Update Date | 2020-10-06 |