| NPI | 1770828303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003840) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004637) |
| Enumeration Date | 2012-12-08 |
| Last Update Date | 2023-03-15 |