| NPI | 1073536587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY002865) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: GA RN057065) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-06-12 |