| NPI | 1932521275 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 4560)  | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: PR 4560)  | 
| Enumeration Date | 2014-01-06 | 
| Last Update Date | 2014-01-06 |