| NPI | 1326250978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY002831) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 1844) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: GA PSY002831) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NC 1844) | |
| 106H00000X Marriage & Family Therapist (Licence: GA PSY002831) | |
| 106H00000X Marriage & Family Therapist (Licence: NC 1844) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-05-23 |