| NPI | 1467654111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL Py8512) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 3888) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2017-04-11 |