| NPI | 1477982791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60401712) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0200X Psychologist Forensic | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |