| NPI | 1891814570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY7174) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY7174) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: FL PY7174) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2009-04-22 |