| NPI | 1770153801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60677390) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ID PSY-203377) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-07-08 |