| NPI | 1811515745 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: FL SS1292) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL SS1292) | 
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL SS1292) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: FL SS1292) | |
| Enumeration Date | 2020-07-07 | 
| Last Update Date | 2020-07-07 |