| NPI | 1578116158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11240) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY60915310) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2022-10-25 |