| NPI | 1730176892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY5632) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY0005832) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2014-02-21 |