| NPI | 1255610531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11197) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 3900) |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2024-01-26 |