| NPI | 1962470088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9288) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: NH 979) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 7698) | |
| 103TC0700X Psychologist Clinical (Licence: NH 979) | |
| 103TC0700X Psychologist Clinical (Licence: MA 7698) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2018-01-02 |