| NPI | 1760600480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 1623) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA PY00003079) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-11-18 |