| NPI | 1154447423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003033) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: TN 2612) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-03-23 |