NPI | 1376722785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA TE00003766) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-202086) |
Enumeration Date | 2007-11-01 |
Last Update Date | 2007-11-01 |