NPI | 1124548029 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60927780) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103T00000X Psychologist (Licence: WA 60927780) | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2022-11-09 |