| NPI | 1568175628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004670) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY004670) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY004670) | |
| 103TC1900X Psychologist, Counseling (Licence: GA PSY004670) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY004670) | |
| 103TF0000X Psychologist, Family (Licence: GA PSY004670) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: GA PSY004670) | |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-03-20 |