| NPI | 1912346339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5044) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60393656) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2018-03-17 |