| NPI | 1255378386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY003274) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 20263) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY003274) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-04-26 |