| NPI | 1689895336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003665) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8262) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2018-10-25 |