| NPI | 1972613115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA 3423) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 253) |
| 103TC0700X Psychologist, Clinical (Licence: WA 3423) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA 3423) | |
| 103TS0200X Psychologist, School (Licence: WA 3423) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-12-08 |