| NPI | 1164624375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 11429) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI 1409) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60689616) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OR 3496) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2023-10-20 |