| NPI | 1124509575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0005359) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60856777) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2020-10-15 |