| NPI | 1265565964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60550073) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AK 558) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2016-02-05 |