| NPI | 1013582303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61373507) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 12588) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-03-18 |