| 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 |