| NPI | 1780905331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY 60084158) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY 60084158) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA PY 60084158) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |