| NPI | 1912281254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60234783) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4165) |
| 103TC0700X Psychologist, Clinical (Licence: MA 9619) | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2024-02-21 |