| NPI | 1487929709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY 60474804) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 019051) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2018-04-11 |