| NPI | 1215450325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003921) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: GA PSY003921) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |