| NPI | 1265705545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8478) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004252) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2021-02-09 |