| 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 |