| NPI | 1790855781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL PY6177) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY6177) |
| 103TH0004X Psychologist Health (Licence: FL PY6177) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-10-20 |