| NPI | 1659528842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA 60712183) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY24092) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2017-01-06 |