| NPI | 1205322237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6129) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: PR 6129) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PR 6129) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2018-07-02 |