| NPI | 1659637304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA MD60641525) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 1182) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2017-04-06 |