NPI | 1790952141 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 2374) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA 2374) |
Enumeration Date | 2008-05-14 |
Last Update Date | 2008-05-14 |