| NPI | 1154849867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY004097) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NC 4956) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2021-01-28 |