| NPI | 1538501952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10650) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 005177) |
| Enumeration Date | 2013-07-26 |
| Last Update Date | 2020-01-23 |