| NPI | 1346217577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA 60604596) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS015276) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2019-05-17 |