| NPI | 1780943142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 2061) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PSYC.PY.60089682) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2012-05-04 |