| NPI | 1437595014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA 2125) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA 2125) |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |