| NPI | 1366424681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 0393) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA 0986) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2013-05-20 |