| NPI | 1285658047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY4836) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03599) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2011-03-30 |