| NPI | 1497963458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8700) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2569) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2015-04-04 |