| NPI | 1629040571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY00000899) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: WA PY00000899) |
| 103T00000X Psychologist (Licence: WA PY00000899) | |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2012-09-19 |