NPI | 1356564272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY 1757) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY 1757) |
Enumeration Date | 2007-04-10 |
Last Update Date | 2025-09-11 |