| NPI | 1679952592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY11982) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: FL PY11982) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-08-28 |