NPI | 1083768402 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003112) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PST000800) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2014-06-13 |