| NPI | 1447657036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60477451) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: WA PY60477451) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA PY60477451) | |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |