| NPI | 1598948440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60192792) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 6124) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2018-12-07 |