| NPI | 1619094570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY1226) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OR 0274) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2013-11-01 |