| NPI | 1962619296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: KS 03328) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60163183) |
| 103TC1900X Psychologist Counseling (Licence: WA PY60163183) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA PY60163183) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-08-14 |