| NPI | 1730479916 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10806)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071007907)  | 
| Enumeration Date | 2011-04-09 | 
| Last Update Date | 2020-09-08 |