| NPI | 1013276138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301017730) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY 60460149) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-12-18 |