| NPI | 1336134121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY002724) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: GA PSY002724) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY002724) | |
| Enumeration Date | 2005-09-17 |
| Last Update Date | 2025-09-11 |