| NPI | 1023454097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: OR C4006) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH60586515) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2019-11-16 |