| NPI | 1235258559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY002216) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 4796) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2018-04-10 |