| NPI | 1578908166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004716)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA PSY004716)  | 
| 103K00000X Behavior Analyst (Licence: 1-20-46254)  | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2013-05-08 | 
| Last Update Date | 2025-01-23 |