| NPI | 1770785933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: GA 3075) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA 3075) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA 3075) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2008-10-27 |