| NPI | 1023359254 |
|---|---|
| Other Name | THERESA CHURCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60128025) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CL60160627) |
| 101YM0800X Counselor Mental Health (Licence: WA LH60432436) | |
| 103TC0700X Psychologist Clinical (Licence: WA PY60128025) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2016-12-22 |