NPI | 1962994681 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61047857) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY61047857) |
Enumeration Date | 2018-05-30 |
Last Update Date | 2021-12-11 |