| NPI | 1588261945 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004435) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: PSY004435) | 
| Enumeration Date | 2020-10-07 | 
| Last Update Date | 2022-07-12 |