| NPI | 1255617841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003511) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PS-P000218) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2015-05-28 |