| NPI | 1225339336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8180) |
| Additional Taxonomies | 103TR0400X Psychologist Rehabilitation (Licence: FL PY8180) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2013-11-12 |