| NPI | 1215385273 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 1889)  | 
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: PR 1889)  | 
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PR 1889)  | |
| Enumeration Date | 2016-06-01 | 
| Last Update Date | 2016-06-01 |