| NPI | 1548312630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY 2015) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 1291) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2015-01-21 |