| NPI | 1023197951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61194123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA 00005653) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2023-06-30 |