| NPI | 1043617707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61001510) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH60859345) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2020-08-26 |