| NPI | 1639173479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00002917) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY2917) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-11-27 |