| NPI | 1518200724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60342353) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004705) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-10-14 |