| NPI | 1790037281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003784) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 091766) |
| 103T00000X Psychologist (Licence: NC 4506) | |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2015-05-12 |