| NPI | 1841699485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8704) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY8704) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2014-08-20 |