| NPI | 1902282486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9638) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MD 05549) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2016-09-29 |