| NPI | 1487964888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 10865) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 1813) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2021-07-13 |