| NPI | 1043765852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60732813) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60532719) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60732813) | |
| 103TC1900X Psychologist, Counseling (Licence: WA PY60732813) | |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2019-06-03 |