| NPI | 1679029144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61163478) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY61163478) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2021-08-06 |