| NPI | 1558970863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39389) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY61091737) |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2022-04-07 |