| NPI | 1144305590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003862) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 012342) |
| 103TS0200X Psychologist School (Licence: NY 012342) | |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-05-19 |