| NPI | 1104166578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY004241) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA PSY004241) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY004241) | |
| 103TH0004X Psychologist Health (Licence: GA PSY004241) | |
| 103TH0100X Psychologist Health Service (Licence: GA PSY004241) | |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2025-05-12 |