| NPI | 1619031069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 1820) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY00002800) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2017-04-25 |