NPI | 1063925600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY04119) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: GA PSY04119) |
Enumeration Date | 2017-11-06 |
Last Update Date | 2017-11-06 |