| NPI | 1750305587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY9061) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 002500) |
| 103TC0700X Psychologist, Clinical (Licence: NY 68015623) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY9061) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-04-11 |