| NPI | 1205201126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003964) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: GA 1142311) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |