| NPI | 1558303834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6460) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI 694) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-12-21 |