| NPI | 1588713812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WA 894) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 894) |
| 1041C0700X Social Worker, Clinical (Licence: WA 5561) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |