| NPI | 1912264870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2172) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA 3257) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2013-07-09 |