| NPI | 1770735318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003019) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1396) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2017-01-12 |