| NPI | 1760409254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 1835) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY00003510) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-11-05 |