| NPI | 1124553508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61306567) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY61306567) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2024-01-19 |