| NPI | 1396220117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10249) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071.010308) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2020-08-17 |