| NPI | 1932645603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 9500) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL 9500) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL 9500) | |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |