| NPI | 1326409574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 2754) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY60853827) |
| 103TC0700X Psychologist Clinical (Licence: ID PSY-203128) | |
| 103TC0700X Psychologist Clinical (Licence: CA PSY28068) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2019-04-25 |