| NPI | 1851605083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY003955) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2019-02-21 |