| NPI | 1114102274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID PSY-202443) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY-60894795) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2021-07-09 |