| NPI | 1629486857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8178) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS008446-L) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |