| NPI | 1285626507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1853) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY00002039) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2011-12-02 |