| NPI | 1366650798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7334) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: FL PY 7334) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-12-26 |