| NPI | 1093285777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW005994) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: GA CSW005994) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2019-06-11 |