| NPI | 1861105017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY004675) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY004675) |
| 103TF0200X Psychologist, Forensic (Licence: GA PSY004675) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: GA PSY004675) | |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-12 |