| NPI | 1184930109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 3474) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: GA PSY003334) |
| 103TS0200X Psychologist School (Licence: GA 35533) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |