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 |