| NPI | 1952749905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA PSY003697) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: GA FORTHCOMING) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2025-02-06 |