| NPI | 1740609932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003765) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY 3977) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-02-04 |