| NPI | 1083996953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60558664) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1259) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2015-12-08 |