NPI | 1275023871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61011113) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY61011113) | |
Enumeration Date | 2018-05-18 |
Last Update Date | 2021-03-11 |