| NPI | 1952486409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 2246) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WA PY3359) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-11-09 |