| NPI | 1235169913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00001310) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ID PSY-279) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-10-05 |