| NPI | 1649499245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TF0200X Psychologist Forensic (Licence: FL PY4921) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY4921) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY4921) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-07-10 |