| NPI | 1376550848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 1035) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: CO 1035) |
| 103TH0100X Psychologist Health Service (Licence: CO 1035) | |
| 103T00000X Psychologist (Licence: CO 1035) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-11-10 |