| NPI | 1568770006 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60275037)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60275037)  | 
| Enumeration Date | 2010-09-17 | 
| Last Update Date | 2021-03-15 |