| NPI | 1891824611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY 3127) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY 13834) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2007-07-08 |