| NPI | 1275718819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7638) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY0002026) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2008-09-04 |