| NPI | 1114106028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1842) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY 00003927) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2009-07-23 |