| NPI | 1619248424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8352) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY8352) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2017-04-06 |