| 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 |