| NPI | 1013091982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003714) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 3178) |
| 103TC0700X Psychologist, Clinical (Licence: OR 2126) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2014-05-05 |