| NPI | 1548270994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY0004692) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 3957) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY0004692) | |
| 103TF0200X Psychologist Forensic (Licence: FL PY0004692) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |