| NPI | 1619090503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8436) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL SW4682) |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2022-02-02 |