| NPI | 1306903562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA 00001186) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 00001186) |
| 103TC1900X Psychologist, Counseling (Licence: WA 00001186) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WA 00001186) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2010-09-24 |