| NPI | 1528187283 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports (Licence: PR 1674)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 1674)  | 
| Enumeration Date | 2007-03-27 | 
| Last Update Date | 2025-09-11 |