| NPI | 1902297385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 589) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 966) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2015-02-06 |