| NPI | 1730406646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY1084) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PL5742) |
| Enumeration Date | 2010-05-02 |
| Last Update Date | 2015-08-04 |