| NPI | 1568512416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60691446) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PSYC.PY.60691446) |
| 174400000X Specialist (Licence: WA MA00015198) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-02-05 |