| NPI | 1881848281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY5516) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: FL PY5516) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY5516) | |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2013-12-06 |