| NPI | 1992998462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL py6704) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL py6704) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL py6704) | |
| Enumeration Date | 2007-08-19 |
| Last Update Date | 2018-12-04 |