| NPI | 1487933040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60463236) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2527) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WA PY60463236) | |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2022-08-30 |