| NPI | 1952735193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10196) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2022-07-17 |