| NPI | 1700116829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8421) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071.007822) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2013-06-18 |