| NPI | 1609201359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003702) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY003702) |
| 103TC0700X Psychologist, Clinical (Licence: GA PSY003702) | |
| 103TC1900X Psychologist, Counseling (Licence: GA PSY003702) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003702) | |
| 103TF0000X Psychologist, Family (Licence: GA PSY003702) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: GA PSY003702) | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2014-02-08 |