| NPI | 1306066832 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY0003146)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810000724)  | 
| Enumeration Date | 2007-04-26 | 
| Last Update Date | 2012-11-06 |