| NPI | 1760708036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY8756) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: IL 071005774) |
| 103TC0700X Psychologist Clinical (Licence: IL 07005774) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2016-11-15 |