| NPI | 1992923502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY 5102) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: FL PY 5102) |
| 103TF0200X Psychologist, Forensic (Licence: FL PY 5102) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL PY 5102) | |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2007-07-08 |