| NPI | 1609937259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 5212) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: GA PSY003749) |
| 103TC0700X Psychologist, Clinical (Licence: GA PSY003749) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2024-09-25 |