| NPI | 1639226467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY002738) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY002738) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA PSY002738) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2018-06-19 |