| NPI | 1679606420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3848) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY5470) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-08 |