NPI | 1215240775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003639) |
Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY003639) |
103TB0200X Psychologist, Cognitive & Behavioral | |
Enumeration Date | 2010-07-26 |
Last Update Date | 2019-08-14 |