| NPI | 1740329176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: SC 1840) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: GA PSY003011) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY003011) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-09-23 |