| NPI | 1750379996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY4602) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY4602) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2007-07-08 |