| NPI | 1992245732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY001479) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY001479) |
| 103TE1100X Psychologist, Exercise & Sports (Licence: GA PSY001479) | |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2022-09-30 |