| NPI | 1629245071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL py8308) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 15453) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2012-03-22 |