NPI | 1043765894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60828639) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-08-22 |
Last Update Date | 2020-01-15 |