| NPI | 1457530891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60676698) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301013777) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2016-09-06 |