| NPI | 1629202668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA py1717) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WA py1717) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |