| NPI | 1487130282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL 10188) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: FL 10188) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL 10188) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL 10188) | |
| 103TF0000X Psychologist Family (Licence: FL 10188) | |
| 103TF0200X Psychologist Forensic (Licence: FL 10188) | |
| 103TH0100X Psychologist Health Service (Licence: FL 10188) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: FL 10188) | |
| 103TS0200X Psychologist School (Licence: FL 10188) | |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2018-07-14 |