| NPI | 1841355211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY2928) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY18750) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-08 |