| NPI | 1104107051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60347698) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH60347698) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2015-09-24 |