| NPI | 1962627950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8358) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW7903) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-12-09 |