| NPI | 1457433468 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL p43869)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103T00000X Psychologist | |
| Enumeration Date | 2006-10-19 | 
| Last Update Date | 2010-10-20 |