| NPI | 1760620504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: WA PY60060689) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: WA PY60060689) |
| 103TC0700X Psychologist Clinical (Licence: WA PY60060689) | |
| 103TF0000X Psychologist Family (Licence: WA PY60060689) | |
| 103TF0200X Psychologist Forensic (Licence: WA PY60060689) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: WA PY60060689) | |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |