| NPI | 1942590831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1623) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY003427) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2016-08-10 |