NPI | 1487998852 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY 60460749) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0003853) |
Enumeration Date | 2012-11-24 |
Last Update Date | 2019-10-07 |