| NPI | 1659433696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003528) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC004768) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2018-03-17 |