| NPI | 1790048650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8446) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY8446) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY8446) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY8446) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY8446) | |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2017-01-24 |