| NPI | 1427471663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8878) |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: FL PY8878) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |