| NPI | 1972696839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6255) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 1163) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-06-25 |