| NPI | 1619982345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 8071) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AK AK560) |
| 103TH0004X Psychologist, Health (Licence: FL 8071) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-11-17 |