| NPI | 1538612551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SC 1353) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY003928) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-12-16 |