| NPI | 1114037900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1553) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA 1437) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-03-23 |