| NPI | 1396051520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60307730) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: KS 1360) |
| Enumeration Date | 2010-08-25 |
| Last Update Date | 2014-08-18 |