| NPI | 1295874543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60161846) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2272) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2018-09-10 |