| NPI | 1467903609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA psy3835) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY3835) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: GA PSY3835) | |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2018-03-17 |