| NPI | 1609828458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4857) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: FL PY 4857) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-01-18 |