| NPI | 1528163425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL py5655) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY-5655) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY-5655) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2021-06-04 |