| NPI | 1356627012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9202) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 04895) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2018-04-08 |