| NPI | 1164648895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60482905) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 2393) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-03-04 |