| NPI | 1700064664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY5982) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY5982) |
| Enumeration Date | 2008-02-03 |
| Last Update Date | 2023-10-22 |