| NPI | 1235487935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY004879) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YM0800X Counselor, Mental Health | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2025-11-12 |