| NPI | 1235204454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5563) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT1482) |
| 106H00000X Marriage & Family Therapist (Licence: MA MH51) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2010-12-16 |