| NPI | 1780992669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AL 1953) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY 8158) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60182923) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2015-12-29 |