| NPI | 1073704714 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TH0004X Psychologist, Health (Licence: GA PSY00347) | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: GA PSY00347) | 
| 103TC1900X Psychologist, Counseling (Licence: VA 0810004105) | |
| Enumeration Date | 2007-08-07 | 
| Last Update Date | 2024-02-29 |