| NPI | 1972663193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6385) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY6385) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY6385) | |
| 103T00000X Psychologist (Licence: FL PY6385) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-07-11 |