| NPI | 1811326028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: TN P0000003317) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY 8901) |
| 103TC0700X Psychologist Clinical (Licence: GA PSY 00364) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2018-03-17 |