| NPI | 1912396771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY61177248) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP5867) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2021-09-29 |