| NPI | 1639459191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60540411) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: CA PSY 24340) |
| Enumeration Date | 2011-08-27 |
| Last Update Date | 2022-01-05 |