| NPI | 1306983424 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY6080) | 
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY6080) | 
| 103TC0700X Psychologist, Clinical (Licence: FL PY6080) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: FL PY6080) | |
| Enumeration Date | 2007-01-30 | 
| Last Update Date | 2021-06-11 |