| NPI | 1386020857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003920) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY003920) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2021-01-28 |