| NPI | 1750533303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY004160) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2765-57) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2018-03-17 |