NPI | 1609929603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY 1728) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 24415) |
Enumeration Date | 2007-01-21 |
Last Update Date | 2011-01-16 |