| NPI | 1003025768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 2828) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: PR 2828) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: PR 2828) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2007-07-08 |