| NPI | 1548254196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA 2799) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: GA PSY #2799) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2021-01-14 |