NPI | 1417390600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60312507) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY60312507) |
Enumeration Date | 2013-04-08 |
Last Update Date | 2013-04-08 |