| NPI | 1518971126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9259) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 2580-057) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071-006671) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2015-05-20 |