| NPI | 1407250079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA 60717708) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2022-07-21 |